Objective To explore the intraoperative nusing risks in elderly patients with oral cancer, and summarize the nursing points. Methods Forty elderly patients with oral cancer were treated with radical resection and partial skin flap repair surgery. The intraoperative risk factors was analyzed and the corresponding nursing measures were performed. Results All the operations were successfully manipulated, with the operation time of 3~11 h, averaged (5.5 ± 0.4)h. Five patients developed with intraoperative blood pressure, 26 had low body temperature. All the symptoms were improved and cured. Conclusion The nursing in the operation room should analyze the nursing risks in details for the elderly patients with oral cancer radical operation and take effective measures to ensure the success of operation.

[Objective] To explore the application of Da Vinci robot in laparoscopic pyeloplasty treatment for pediatric hydronephrosis and to improve the effect of operation and shorten the operation time effectively.[Methods] A summary and analysis was performed on the intraoperative cooperation about the clinical data of 14 pediatric hydronephrosis cases (16 sides) whom were performed RALP from November 2015 to July 2016.The intraoperative cooperation includes preoperative education,adequate preparation of surgical instruments,ensuring the normal operation of robot system before surgery and also,the proper body positions,the protection for patients,the establishment of aseptic barrier during operation as well as the maintenance of robot after operation.[Results] All procedures were performed via transperitoneal approach.Docking time was shortened from 40 to 20 min,operation time lasted (115± 38) min.One severe case presented with anastomasis stenosis even after PCN dilatation,and was redid dismembered pyeloplasty half a year later and the ultimate result was good.The other cases recovered well and the overall success rate was 93.75％.There were no robot failure caused by improper cooperation and no complications caused by improper nursing among the 14 pediatric hydronephrosis cases (16 sides) in pediatric hydronephrosis operations.[Conclusion]Da Vinci robot performed well in assisting laparoscopic pyeloplasty treatment for pediatric hydronephrosis,for it leaves light surgical trauma and short duration of operation.Adequate preoperative preparation,medical staff's formal professional technical training and professional cooperation team can not only improve the operation efficiency,but also be the key to the success of the operation.

[Objective]To investigate the inhibitory effect and mechanism of the microRNA-320d(miR-320d)on epithelial mesenchymal transition in endometrial carcinoma JEC cells.[Methods]JEC endometrial carcinoma cell lines were transfected with miR-320d mimics or negative control mimic,respectively,as M320d or NCM group. Control group was established with untreated JEC endometrial carcinoma cells. miR-320d content in each group was detected by RT-PCR method. Transwell assay was used to detect the migration and invasion ability of the 3 groups. Western-blot assay was used to detect the expressions ofα-Catenin,E-cad-herin,Vimentin and PBX3 protein in 3 groups. Antagonistic effect of PBX3 overexpression on miR-320d inhibition of EMT was detect-ed by western blot assay. The relationship between miR-320d and PBX3 was detected by dual luciferase assay.[Results]The expres-sion level of miR-320d in M320d group was significantly up-regulated,and the expression level of miR-320d was 808.25 ± 15.58 times higher than that of control group(P<0.05). The number of migrating cells in M320d group was 29.56 ± 0.59,which was signif-icantly lower than that of control group at 94.48 ± 1.02(P < 0.05). The number of invasive cells in M320d group was 7.33 ± 0.84, which was significantly lower than that of group control 86.28 ± 3.51(P < 0.05). Compared with control group ,the expression of α-Catenin and E-cadherin protein was significantly increased ,the expression of Vimentin protein was significantly decreased ,and the expression of PBX3 protein was significantly decreased. After PBX3 overexpression,the expression ofα-Catenin and E-cadherin protein were significantly decreased,the expression of Vimentin protein were significantly increased. Dual luciferase assay showed that PBX3 is a downstream target gene of miR-320d(P<0.05).[Conclusion]miR-320d may inhibit the expression of EMT related protein through the downstream target gene PBX3 and inhibit the epithelial mesenchymal transition function of endometrial carcinoma JEC cells.

Objective To investigate the nursing risks in the patients undergoing radio-frequency ablation surgery during cardiac valve replacement.Methods The nursing risks in 110 patients undergoing radio-frequency ablation surgery during cardiac valve replacement were summarized to include disorder of water electrolyte and acid-base balance, arrhythmia,hypothermia,skin ulcer,reduction of effective circulating blood volume,infection and so on, so as to carry out the corresponding nursing measures. Results Ventricular fibrillation occurred in 11 patients,hypothermia after rewarming on cardiopulmonary bypass in 31 patients,left atrial bleeding after aortic de-clamping in 1 patient.All the complications were successfully controlled by corresponding management. The operation time ranged from 178 mins to 310 mins and average time was(245.32±34.40)mins.Conclusion The full-scale assessments and effective nursing interventions are the key points to improve the efficiency and success of cardiac valve replacement combined with radio-frequency ablation.

Objective To investigate the nursing points and the effect of the conjoint liver and kindey transplantation. Methods To review the concreted nursing experience among 13 patients who have accepted the conjoint liver and kidney transplantation from 1996 to 2004 in the First Affiliated Hospital of Sun Yat-Sen University,and then summarized the nursing key points of the operation. Results All the nursing measures during the course of operation were properly,the means time of operation was 9.5 hours,the means time of liverless was 65 minutes,the blood loss volume was 7 000 ml. Conclusion The nursing key points of conjoint liver and kidney transplantation include sufficient nursing prepare,homoiothermism during the operation,proper using drugs, proper blood-transfusion and fluid infusion.

Objective To explore the application effect of postural animation video instruction mode in elderly patients undergoing epidural anesthesia. Methods A total of 300 patients with epidural anesthesia were registered from January 2015 to February 2016. The patients were divided into trial group and control group with 150 cases each. The trial group was preoperatively interviewed by the postural anatomy video instruction mode, and the control group was only preoperatively interviewed by oral interpretation. The epidural anesthesia effect and anxiety between the two groups were compared. Results The difference of anesthesia posture and anatomical position, the average time of epidural puncture, the success rate of one puncture and the degree of anxiety before and after mission were 90.67% (136/150), (14.50 ± 10.20) s, (425.60 ± 78.30) s, 97.33% (146/150) and (21.65 ± 6.62) points respectively. The control group was 22.00%(33/150), (112.60 ± 60.80) s, (589.40 ± 90.70)s, 82.67%(124/150) and (6.65 ± 5.40) points respectively. There were significant differences between the two groups (χ2=8.79, t=13.54-19.88, all P < 0.01). Conclusions The postural anatomical video teaching mode can relieve anxiety, improve the degree of fit of epidural anesthesia and the success rate of puncture, shorten the time of posture, thus shorten the average time of epidural puncture, improve the quality of nursing in the operating room, work efficiency.

Objective To investigate the risk factors and preventive measures of liver transplantation in patients with liver cirrhosis complicated with portal hypertension. Methods About 63 patients with cirrhosis and portal hypertension were treated with liver transplantation in our hospital from June 2014 to June 2016. The risk factors were investigated and the corresponding care measures were taken. Results All the 63 patients underwent the operation successfully. The total operation time ranged from 276 to 750 min, averaged (450.52 ± 25.43) minutes. The intraoperative blood loss was 300~5,600 mL, averaged (1693.06 ± 193.24) mL. Intraoperative blood transfusion ranged from 0 to 3,000mL, with an average (1400.50 ± 400.61) mL. Three patients contracted gastrointestinal bleeding after liver implants, which was cured after timely treatment and 5 patients with sacral pressure red tail, improved after treatment. Conclusion Due to the long operation time, bleeding, low temperature, risks of infection and other factors, pre-assessment of the intraoperative risks and relative coping measures are of great significance for the complete of operations.

Objective:To explore the preventive effect of disposable incision protector on incision infection in patients with hepatolithiasis after open hepatectomy.Methods:A retrospective collection of patients with hepatolithiasis who underwent open hepatectomy with a disposable incision protector from January 2015 to December 2018 in the First Affiliated Hospital of Sun Yat-sen University was used as the intervention group. At the same time, patients with hepatolithiasis who did not use the incision protector to undergo partial hepatectomy from January 2012 and December 2014 were collected as the control group. Propensity matching analysis was used to reduce case selection bias and incidences of postoperative incision infection between the two groups were compared before and after matching.Results:In the primary cohort, there were 245 patients in the intervention group and 201 patients in the control group. Patients in the intervention group were younger than those of the control group ( P<0.05) . The proportion of patients with a history of biliary tract surgery in the intervention group was lower than that of the control group, and the operation time was shorter than that of the control group (all P<0.05) . The incidence of incision infection in the intervention group before matching was 5.7% (14/245) , lower than 15.9% in the control group (32/201) , and the difference was statistically significant (χ 2=4.436, P=0.035) . After propensity matching, 165 pairs of patients were generated, there were 165 patients in each group. There was no statistically significant difference in clinical baseline variables between the two groups ( P>0.05) . In the matching cohort, the incidence of incision infection in the intervention group was 7.9% (13/165) , which was lower than 15.2% (25/165) in the control group, and the difference was statistically significant (χ 2=4.283, P=0.039) . Conclusions:The disposable incision protector can effectively prevent postoperative incision infection in patients undergoing open hepatectomy for hepatolithiasis.

Objective To investigate the application and effectiveness of the 90°oblique lateral decubitus position in retroperi-toneal laparoscopic urological surgery,providing a clinical approach to effectively reduce the incidence of pressure injuries on the skin.Methods A retrospective study was conducted on 60 urology patients who were admitted to the Department of Urology in our hospital from September to December 2023 for retroperitoneal laparoscopic surgery.The patients were divided into a traditional group and a trial group based on the surgical position,with 30 patients per group.A conventional 90°lateral decubitus position during surgery was applied to the patients in control group,while a 90°oblique lateral decubitus position was offered to the patients in trial group.The two groups were compared in terms of the incidence rate of skin pressure injury,lumbar back pain on the healthy side within 24 hours after surgery and the score of satisfaction from the surgical team.After controlling for demographic variables using logistic regression analysis,the risk of intraoperative pressure injury occurrence in the two groups of patients was found to be related to the group type.The risk of occurrence in the control group was 6.22 times that of the trial group.Results The observation group demonstrated a significantly lower incidence rate of postoperative skin pressure injury,a significantly lower postoperative lumbar back pain on the healthy side within 24 hours,and a significantly higher score in the surgical team satisfaction compared with those of the control group(all P<0.05).Conclusion In retroperitoneal laparoscopic urological surgery,the 90° oblique lateral decubitus position shows a superiority to the conventional lateral decubitus position in reducing the incidence rate of postoperative pressure injury and decreasing the lumbar back pain on the healthy side.

Objective To investigate the effectiveness of team-based learning(TBL)combined with research-based learning(RBL)in enhancing evidence-based nursing practice skills of undergraduate nursing interns.Methods A total of 114 undergraduate nursing students who interned in the operating room of a ⅢA hospital in Guangzhou from July 2021 to April 2022 were selected as study subjects.A randomized cluster sampling method based on a random number table was used to divide the students into a control group and a trial group.The control group received traditional teaching methods,while the trial group was taught using a combination of TBL and RBL.The two groups were compared in terms of evidence-based practice skills,critical thinking abilities,and their evaluations on the teaching methods.Results The differences in evidence-based practice skills and critical thinking abilities before and after the internship were significantly higher in the observation group compared to the control group(t=35.108,35.897;both P<0.05).Additionally,post-internship evaluation scores for the teaching methods in the trial group were significantly higher than those in the control group(t=-17.580,P<0.05).Conclusion TBL combined with RBL effectively enhances the evidence-based nursing practice skills and critical thinking abilities of undergraduate nursing interns.This approach also improves students'evaluations on the teaching methods and fosters the cultivation of excellent clinical evidence-based nursing professionals.